Blood testing results ranged from 0.3 micrograms/liter (or ppb, parts per billion) to 1,125.6 micrograms/liter or ppb, and the geometric mean of PFOA in blood among the sampled residents was 10 ppb — five times higher than the geometric mean of PFOA believed to be present in the blood of most Americans (which is 2.1 ppb, a figure likely resulting from our ubiquitous exposure to Teflon chemicals that were present in everyday consumer products: nonstick coated cookware, stain-resistant carpets and upholstery, water-resistant clothing, paper and cardboard food packaging, and fire-fighting foam). The health advisory went on to list the known health effects reported with exposure to PFOA, and requested of my husband: “If you have a patient that you think is experiencing health effects due to PFOA exposure, please call us at 1-800-439-8550.”

In general, the higher the PFOA concentrations in drinking water, the higher the PFOA concentration in blood. Some studies have even shown that PFOA levels in blood serum can be up to 100 times higher than the levels found in drinking water — meaning that if someone has 2,000 ppt (parts per trillion) in their drinking water, the anticipated level of PFOA in their blood might be as high as 200,000 ppt (or 200 ppb), an order of magnitude difference.

Why? Because PFOA is like, well, Teflon… resistant, persistent, hard-to-break-down. The half-life of PFOA is between 2-4 years, which means it takes up residence in the body and accumulates faster than the body can expel it — doing what exactly, we’re still not sure, except perhaps, as suggested by the limited epidemiological evidence compiled so far, wreaking havoc on the thyroid, the kidneys, the intestines, the liver. In other words, a baby born with PFOA in its blood has essentially become a chemical harbor until it grows up to be a toddler, or even a preschooler, before PFOA can be completely evicted from its system. Assuming, of course, that the exposure has been removed.

When my husband was first studying to become a physician, he was required to take a class on the history of medicine. I can remember him showing me a graph of total fatalities mapped over time, and pointing to a distinct drop in the curve — a place where something had caused some miraculous reduction in deaths from infectious disease. What was it? Antibiotics? Vaccines? Nope. It was sanitation. Removal of waste from drinking water resources. According to an article on longevity published in Slate.com, “Clean water may be the biggest lifesaver in history. Some historians attribute one-half of the overall reduction in mortality, two-thirds of the reduction in child mortality, and three-fourths of the reduction in infant mortality to clean water.” The discovery of penicillin appeared to yield but a relative blip on the graph my husband showed me, as did the proliferation of vaccines (not to diminish the importance of either to the improvement of public health), but nothing impacted public health with such magnitude as the removal of waste from water. “The garbage man does more to save lives than I ever will,” my husband said.

In Parkersburg, West Virginia, a place considered by many to be ground zero for PFOA-related contamination and injury, DuPont dumped thousands of tons of PFOA into the Ohio River, unlined ponds and beyond, causing widespread contamination of surface and drinking water resources in Parkersburg and surrounding communities. In Hoosick Falls, New York, mishandling of PFOA at the Saint-Gobain plastics facility around the corner from the water supply well on Water Works Road has resulted in contamination of the community water supply. Investigation of the former ChemFab facility will do doubt yield similar findings about disposal of PFOA materials, and during my latest trip to Pownal, Vermont, I was shocked to see that the proximity of the former Mack Molding plastics site to one of the community’s water supply wells was a mere 1,000 feet.

Contamination of drinking water from industrial waste is not a new issue, but these latest developments with PFOA raise the issue yet again, that in this day of modern medicine and sophisticated cancer treatment technologies, we continue to ignore the basic, most fundamental premise of medicine: that the most significant positive impact on human health is the separation of waste from water.

Of course, the implementation of Superfund laws and clean-up programs, and the cradle-to-grave hazardous waste regulations provide some measure of protection, but the exemptions are plenty and the funding is not. Too many waste disposal sites are left festering due to insufficient funds and political commitment for investigation and remediation, and too many water supplies remain in harm’s way.  I keep wondering, after each new discovery of contaminated drinking water wells, of impacted populations whose ailments will likely be traced back to what they drank — I keep wondering if we are ever going to wake up to this fundamental premise of public health.

The post Public Health Advisory: On Water and Waste appeared first on Mary Heather Noble.

But no matter how savvy I think I am about the science, or how much people like me tend to believe that science is what’s going to save us, there is but one essential discipline whose role is really the driver of this bus.

Remember that phrase coined by political strategist James Carville in the 1990s? “It’s the economy, stupid.” Well, I can’t seem to get that phrase out of my head… again. And while Carville’s point back then may have been to emphasize the importance of the struggling economy in the 1992 presidential election, my point in resurrecting the phrase is this: It doesn’t matter how the science explains the cause-and-effect relationships involved in an environmental health crisis. What really matters is the why it happened — which, unsurprisingly, is almost always a matter of economics.

Take Flint, MI, for instance. Sure, I understand the science behind what’s happened:  Water drawn from the Flint River and delivered to Flint’s municipal water customers from spring of 2014 on was more corrosive than the City of Detroit water they had been using prior to then, so the new water literally ate through their aging infrastructure, causing lead and other particulates to pour from their taps. Chemistry 101, right?

But the science doesn’t explain how Flint River water got into the pipes in the first place, nor does it explain why months passed without any corrective action, despite complaints from residents about the visible contamination of their drinking water. Science also fails to provide an acceptable explanation for why Flint pediatrician Mona Hanna-Attisha was belittled and attacked when she released her findings that the percentage of Flint children with abnormally high blood lead levels had doubled since the City switched its water supply. Or why it wasn’t until late December and early January that authorities declared the continued lead poisoning of Flint’s children as the emergency that it was.

More than a year of daily, chronic exposure to lead-contaminated water has occurred in hundreds of Flint households — in a predominately African American community where over 40% of the population lives below the poverty level. Science? No, I think another discipline might be at play. You can almost see the words in the thought bubbles hanging above the City and State officials’ heads: It’s just for a few more months. Really, what difference does it make?

There’s an important term that is often tossed around in civil discourse about economics: “moral hazard.”  Moral hazard refers to the elevated risks one party might take in an economic transaction because another party will bear the negative consequences of those risks. We heard a lot about moral hazard around the Wall Street bank bailouts in 2008, and we often hear conservative grumbling about the moral hazards of the Affordable Care Act —or any social service program, for that matter— and how it isn’t fair for the taxpayers to pay for someone else’s (potentially irresponsible) personal choices.

But the concept of moral hazard is seldom discussed around matters of environmental or personal harm, when the asymmetry of risk involves something other than cold hard cash. Which seems misguided, since the underlying presence of unfairness is the same. Think about it: What if the moral hazard threatens one party’s ability to breathe? The ability to drink clean water? The ability to go to school or play in a city park without getting shot? Where are the conservatives then?

I don’t present this idea as a theoretical argument, because unabated moral hazards are yielding environmental and human health tragedies as we speak. Consider for a moment the economic equation controlling gun regulation in this country.

Consider the matter of DuPont in Parkersburg, WV, where, for decades, the company dumped thousands of tons of perfluorooctanioc acid waste (PFOA, formerly known as C8, the main ingredient in Teflon) into the Ohio River, unlined ponds and beyond, causing widespread contamination of surface and drinking water resources in Parkersburg and surrounding communities. DuPont not only exposed thousands of people to a toxic chemical, they actively concealed the known health effects of PFOA (identified in their own internal toxicology studies) for decades, so they could continue to bring in over $1 billion per year in profit from their highly successful Teflon products (read the recent New York Times article about the case here, a Huffington Post article about it here, and a slightly older one from The Intercept here).

DuPont had even developed a different chemical to replace PFOA in the early 1990s—one that was reportedly less persistent in the environment and stayed in the body for a shorter duration of time— but the company ultimately decided against replacement because the economic risk was too great.  Of course, when the exposure imposed upon workers of DuPont and the 70,000 people served by PFOA-tainted drinking water systems is factored into the equation, along with the link between PFOA and birth defects, kidney cancer, testicular cancer, thyroid disease, and other serious ailments, one wonders where the asymmetry of risk really falls.

—Which brings me back to my point: This is an economic equation, a deeply unbalanced one that is designed to limit the loss of profits, the loss of dollars and cents. Until we start attaching appropriate value to the lives at stake in these institutional transactions, I’m afraid the science is never going to be able to catch up to our inevitable loss.

Photo credits:

npr.org

dispatch.com, Chris Russell, Dispatch file photo

The post Moral Hazard: It’s More than Economics, Stupid appeared first on Mary Heather Noble.

PFCs have been the subject of intense debate for many years, after research confirmed the persistence of long-chain PFCs both in the environment and in people’s bodies, potentially increasing the risk of cancer and other health issues.  As a result, and under pressure from regulatory agencies, DuPont removed one of these chemicals, perfluorooctanoic acid (or PFOA, also known as “C8”), from its Teflon product line, and has since replaced C8 with other chemicals.

Now the spotlight is on these replacement PFCs, known in the chemical industry as poly- or perfluoroalkyl substances (PFASs).  At issue is whether manufacturers should be allowed to use these second-generation PFCs in consumer products, without knowing the full-scale environmental health effects of this “new crop.”  While the American Chemistry Council argues that the new generation of PFCs are safer alternatives to the chemicals they have replaced, many toxicologists anticipate negative effects from these alternative compounds, on the basis that they reside in the same family, and exhibit many of the same properties as the original toxic compounds.

The rush to replace one class of harmful substances with another “less harmful” alternative is nothing new to the American marketplace.  Exhibit A: the replacement of environmentally persistent organochloride pesticides (such as DDT, aldrin, and dieldrin) with a new class of pesticides called organophosphate chemicals.  Exhibit B: the replacement of tetra-ethyl lead in gasoline with methyl-tertiary-butyl-ether, or MTBE.  And most recently, the phasing out of bisphenol A (BPA), in favor of bisphenol S (BPS) in common plastic goods.

But the extent to which “less harmful” is known before unleashing substitute chemicals on the American public has been, and continues to be an unfocused concept.  Consider: years after their pervasive use on American food crops, organophosphate chemicals (which were derived from military nerve agents used in chemical warfare) — the supposed “safer” class of pesticides — are now being implicated in the increased incidence of neurodevelopmental conditions, as well as the increasing incidence of childhood brain cancers.

And MTBE — once hailed as the “environmentally friendly” gasoline additive used to reduce emissions of smog-producing air pollutants — turned out to be a rogue replacement as well, a compound so soluble and mobile in the subsurface that it quietly knocked out 70% of Santa Monica, California’s drinking water wells before its toxicologic properties were really even known (see the original “60 Minutes” feature on MTBE here.)   In fact, the health effects from exposure to MTBE are still being investigated, and though the EPA has identified the chemical as a possible human carcinogen, the agency has yet to establish a Maximum Contaminant Level for MTBE in drinking water.

In my own environmental remediation days, MTBE was known as a “runner” — a chemical that traveled so quickly in soil and water that its addition to gasoline pumps in the 1990s significantly lengthened the geographic footprint of gasoline plumes from leaky underground storage tanks.  Perhaps the most frustrating aspect was the predictability of the scenario we saw playing out in the field.  Anyone who understood the chemical properties of MTBE should have anticipated what could happen when you put a chemical like that into an underground storage tank located above a drinking water aquifer…

We have yet to understand the impacts of BPS, currently standing in for the BPA that recently leached from our baby bottles and plastic food containers, let alone the environmental health consequences of this new generation of PFCs.  But we can make some educated guesses.  Based upon our current modus operandi, we can be sure that we will find them in our environment, our food, and our bodies before we really know.

It’s all too easy to look at the presence of these chemicals in our environment, in ourselves, as some kind of cosmic event over which we had no control, like Pandora’s Box. But in so doing, we conveniently excuse ourselves from acknowledging the active role we are taking in our own self-destruction.  By blaming Pandora, we abstain from the responsibility we have as intelligent human beings to anticipate these outcomes based upon 1) documented history, and 2) scientifically possible outcomes.  We know damn well what can happen because we have already seen what can happen.  By turning a blind eye and allowing replacement chemicals to enter the market without sufficient study, all we are doing is continuing a legacy of non-consensual experimentation.  On ourselves, on future generations.

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